Objective: Prospective longitudinal long-term follow-up study of a sample of children with hemifacial microsomia treated by mandibular distraction osteogenesis (DO) with and without the addition of a functional orthopedic treatment.
Material and Method: Twenty patients with type I and II hemifacial microsomia were treated with a combined orthodontic-distraction protocol.The mean age at the beginning of treatment was 6.7 years.
Ten patients with an average age of 6.2 years were treated by distraction only.Vertical changes were measured on CBCT, postero-anterior cephalometrics and panoramic radiographs taken at different time points.
Results: Angular changes of infraorbital and nasal floor plane were not significant after age of 5.Mandibular vertical changes showed a gradual return of asimmetry in all patients, diminished in the group treated with functional appliances, which mantain a slightly better occlusal plane, but not the mandibular symmetry.
Conclusion: Distraction osteogenesis should be applied after careful patient selection.In type I and II hemifacial microsomia a combined orthodontic-surgical treatment is strongly recommended.